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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04112992
Registration number
NCT04112992
Ethics application status
Date submitted
30/09/2019
Date registered
2/10/2019
Titles & IDs
Public title
An International, Multicenter, Prospective Registry on Post-traumatic Long Bones Defects
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Scientific title
An International, Multicenter, Prospective Registry to Investigate Treatment Options and Their Outcomes on Post-traumatic Long Bones Defects
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Secondary ID [1]
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LoBoDe Registry
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Limb Fracture
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Bone Loss
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Condition category
Condition code
Intervention/exposure
Study type
Observational [Patient Registry]
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Treatment: Surgery - Any treatment that is used for a defect of any long bone
Treatment: Surgery: Any treatment that is used for a defect of any long bone
Any treatment that is used for a defect of any long bone. All treatments are based on individual clinician's judgement and the patient characteristics. The registry does not dictate any specific treatment.
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Intervention code [1]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Baseline characteristics
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Assessment method [1]
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Demographics, medical history, comorbidity
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Timepoint [1]
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Pre-operative
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Primary outcome [2]
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Bone defect details
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Assessment method [2]
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* Affected bone
* Localization: Proximal 1/3rd, middle 3rd, distal 1/3rd(for any bone)
* Size (categorization according Karger classification; definition: a bone defect should be at least 2 cm (Karger Type II)) Type II: 2-5 cm Type III: 5-10 cm Type IV: \> 10 cm
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Timepoint [2]
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Pre-operative and/or intraoperative
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Primary outcome [3]
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Trauma assessment
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Assessment method [3]
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* Injury Severity Score (ISS): Grading for each item (points): No injury (0), Minor (1), Moderate (4), Serious (9), Severe (16), Critical (25), Unsurvivable (75)
* Assessment:
* Head and neck worst injury
* Face worst injury
* Chest worst injury
* Abdomen worst injury
* Extremity (including pelvis) worst injury
* External worst injury
* Gustilo \& Anderson classification for open fractures
* Type I
* Type II
* Type IIIA
* Type IIIB
* Type IIIC
* Tscherne classification for closed fracture and soft-tissue injuries
* Grade 0
* Grade 1
* Grade 2
* Grade 3
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Timepoint [3]
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Pre-operative and/or intraoperative
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Primary outcome [4]
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evaluate the bone defect in the context of previous interventions
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Assessment method [4]
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Number of previous interventions: \<2, \<4, \>4
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Timepoint [4]
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Intraoperative
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Primary outcome [5]
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Surgical details & Intraoperative findings 1
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Assessment method [5]
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* Procedure type:
* One stage
* Staged (e.g. Masquelet technique / distraction osteogenesis / bone transport)
* Ilizarov
* Bone quality (good, fair, poor) by surgeon's discretion
* Soft tissue and vascularity (good, fair, poor) by surgeon's discretion
* Contamination (yes/no)
Specification:
* Metal from a bullet
* Metal from a pole
* Other Metal
* Wood
* Soil
* Others
* Surgical time (min)
* Stabilization technique: Internal device (extra- or intramedullary) / External device (For both, drop down menu will be used)
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Timepoint [5]
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Intraoperative
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Primary outcome [6]
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Surgical details & Intraoperative findings 2
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Assessment method [6]
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* Bone grafting
* Autografts
* Allograft(s)
* Other synthetics
* If applicable - time to harvest graft (in minutes)
* Graft enhancement yes / no
* Demineralized bone matrix (DBM)
* Bone morphogenetic protein (BMP)
* Stem cells
* Platelet rich plasma (PRP)
* Other
* Soft-tissue / vascular / microsurgical procedure yes / no
* Skin graft
* Local flap
* Free flap
* Additional treatment
* Systemic antibiotic treatment yes / no
* Local antibiotic treatment yes / no
* Post-operative use of a negative pressure dressings (NPWT) or vacuum-assisted closure (VAC) system yes / no
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Timepoint [6]
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Intraoperative
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Primary outcome [7]
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Functional Outcome
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Assessment method [7]
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- Assessment of limb function and loss of length
* Definition: anatomic shortening of the limb in comparison to the contralateral side
* Assessment in cm
* Any orthotic used to equalize leg length
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Timepoint [7]
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6 months follow-up / 12 months follow-up and/or 6 months after bone union (max 12 months)
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Primary outcome [8]
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Patient related outcome / Quality of life 1
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Assessment method [8]
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Patient-Reported Outcomes Measurement Information System (PROMIS)
* Physical function: This item measures self-reported capability rather than actual performance. It includes the functioning of lower extremities (walking or mobility) as well as instrumental activities of daily living, such as running errands. We will use the short form 10b.
* Physical function, upper extremity: This item measures activities that require use of the upper extremity including shoulder, arm, and hand activities. Examples include writing, using buttons, or opening containers. We will use the short form 7.
* Pain Interference: This item assesses self-reported consequences of pain on relevant aspects of one's life. This includes the extent to which pain hinders engagement with social, cognitive, emotional, physical, and recreational activities. We will use the short form 8a.
Short forms will be used in all sites possible (i.e. where the translation is available).
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Timepoint [8]
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Screening / 6 months follow-up / 12 months follow-up and/or 6 months after bone union (max 18 months)
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Primary outcome [9]
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Patient related outcome / Quality of life 2
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Assessment method [9]
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EQ-5D-3L assessment (Five items, 3-point categorical scale) The EQ-5D-3L descriptive system comprises the following five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 3 levels: no problems, some problems, and extreme problems.
o The EQ VAS records the patient's self-rated health on a vertical visual analogue scale where the endpoints are labelled 'Best imaginable health state' and 'Worst imaginable health state'. The VAS can be used as a quantitative measure of health outcome that reflects the patient's own judgement.
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Timepoint [9]
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Screening / 6 months follow-up / 12 months follow-up and/or 6 months after bone union (max 18 months)
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Primary outcome [10]
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Radiological Outcome
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Assessment method [10]
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Pre-operative/intraoperative
* Deformity parameters (if applicable)
* Nonunion classification: Hypertrophic, Oligotrophic, Atrophic Follow-up visits
* Bone healing (based on the treating physician's judgement): Not healed / Partially healed / Mostly healed / Healed
* Evaluation of the expansion of the bone defect: bone defect size
* Time to healing: Date when full healing is achieved (to be calculated days from index surgery)
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Timepoint [10]
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Screening / / Intraoperative / 6 months follow-up / 12 months follow-up and/or 6 months after bone union (max 18 months)
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Eligibility
Key inclusion criteria
* Age = 18 years
* Skeletally mature
* Post traumatic bone defect > 2 cm either
* initially after injury or
* after surgical debridement
* Informed consent obtained, i.e.:
* Ability to understand the content of the patient information/ICF
* Willingness and ability to participate in the clinical investigation according to the registry plan
* Signed and dated EC/IRB approved written informed consent OR
* Written consent provided according to the IRB/EC defined and approved procedures for patients who are not able to provide independent written informed consent
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Any oblique defect that has less than 8cm expansion when adding the defect size of all four cortices
* Any not medically managed severe systemic disease
* Pregnancy
* Prisoners
* Participation in any other medical device or medicinal product registry within the previous 3 months that could influence the results of the present registry
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Study design
Purpose
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Duration
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Selection
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
3/07/2024
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
30/03/2029
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Actual
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Sample size
Target
600
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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John Hunter Hospital - Newcastle
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Recruitment postcode(s) [1]
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2310 - Newcastle
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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California
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Country [2]
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United States of America
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State/province [2]
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Ohio
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Country [3]
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United States of America
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State/province [3]
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Oklahoma
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Country [4]
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Argentina
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State/province [4]
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Buenos Aires
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Country [5]
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Chile
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State/province [5]
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Valdivia
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Country [6]
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Colombia
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State/province [6]
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Bogotá
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Country [7]
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Colombia
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State/province [7]
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Medellín
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Country [8]
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Germany
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State/province [8]
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Frankfurt
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Country [9]
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Germany
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State/province [9]
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Gießen
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Country [10]
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Germany
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State/province [10]
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Heidelberg
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Country [11]
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Germany
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State/province [11]
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Münster
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Country [12]
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India
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State/province [12]
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Patna
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Country [13]
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Korea, Republic of
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State/province [13]
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Daegu
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Country [14]
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Netherlands
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State/province [14]
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Maastricht
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Country [15]
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Netherlands
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State/province [15]
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Nijmegen
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Country [16]
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South Africa
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State/province [16]
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Cape Town
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Country [17]
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Switzerland
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State/province [17]
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Zürich
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Country [18]
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United Kingdom
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State/province [18]
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Leeds
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Funding & Sponsors
Primary sponsor type
Other
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Name
AO Innovation Translation Center
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
Long bone defect (LBD) is defined as a focalized loss of bone tissue in any long bone of the upper or lower extremity. Long bone defects are a complex problem, that may arise as a complication of many different pathologies, such as trauma, tumors or infection. Whereas post-traumatic defects are the largest group. Reports estimate that there are almost 4 million bone grafting procedures worldwide per year. However, limb reconstruction in the context of a bony defect is challenging and up to date there is little evidence and treatment recommendations. In a multi-national approach, the aim of this project is to set up an international, multicenter registry to gather information and details on prevalence or incidence, current treatments, complications and outcome.
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Trial website
https://clinicaltrials.gov/study/NCT04112992
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Hans-Christoph Pape, MD
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Address
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University Hospital Zurich Department of Trauma Surgery
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Alix Frischknecht
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Address
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Country
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Phone
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+41 79 606 41 48
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Undecided
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04112992